Efficacy of two doses of external counterpulsation (ECP) on glycemic control in people with type 2 diabetes mellitus: A randomized SHAM-controlled trial

Aims: To determine the efficacy of two doses of external counterpulsation (ECP) on glycemic control in people with type 2 diabetes mellitus (T2D), and any persistent benefits 7 weeks following treatment. Methods: 50 participants with T2D were randomly assigned to either 1) 20x45-minute ECP sessions over 7 weeks (ECP45), 2) 20x30-minute ECP sessions over 7 weeks (ECP30) or 3) SHAM control. Outcomes were assessed at baseline, after 7 weeks of the intervention and 7 weeks after the interventions finished. Efficacy was determined from changes in HbA1c. Results: After 7 weeks, there were significant between-group differences, with ECP45 lowering HbA1c compared to SHAM (mean [95% CI] -0.7 [-0.1 to -1.3] %; -7 [-1 to -15] mmol/mol). Within group changes were; ECP45 (mean +/- SD -0.8 +/- 0.8%; -8 +/- 8 mmol/mol), ECP30 (-0.2 +/- 0.5%; -2 +/- 6 mmol/mol) and SHAM (-0.1 +/- 0.9%; -1 +/- 10 mmol/mol). HbA1c in the ECP45 group remained lower 7 weeks after completing the intervention; ECP45 (7.0 +/- 1.1%; 53 +/- 26 mmol/mol), ECP30 (7.7 +/- 1.4%; 60 +/- 16 mmol/mol) and SHAM (7.7 +/- 1.0%; 60 +/- 10 mmol/mol). Conclusions: In people with T2D, ECP45 for 7 weeks improved glycemic control when compared to ECP30 and a SHAM control group.